Tanaka Kenichi, Yamashita Hironori, Gon Hidetoshi, Nakajima Takayoshi, Kanemitsu Kiyonori, Okuda Toyokazu, Toyokawa Akihiro, Iwasaki Takeshi, Ishida Takeshi
Dept. of Surgery, Yodogawa Christian Hospital.
Gan To Kagaku Ryoho. 2011 May;38(5):815-8.
This case is a 69-year-old woman. We diagnosed gastric cancer and cholecystolithiasis by close inspection of abdominal pain. Because preoperative diagnosis was T2N0M0, Stage I B, we performed an operation. Many lesser tubercles were shown, and were diagnosed as peritoneal metastases pathologically. The tumor in corpus ventriculi infiltrated out of gastric serosa. We judged that curative resection was impossible and finished the operation after giving an intra-abdominal dosage of cisplatin(CDDP)at 85mg. After operation, 3 courses of performed S-1/CDDP combination chemotherapy were performed. Because we observed contraction of the main lesion and could not point out the peritoneal metastases and ascitis, we performed a second look operation. All the nodules found with peritoneal and rectouterine excavation had disappeared and we performed distal gastrectomy. The postoperative diagnosis was pT2(MP), pN0CY0, Stage I B, Cur A, therapy grade 1a. Chemotherapy does succeed, and this is a valuable case in which a radical operation could be performed.
该病例为一名69岁女性。通过对腹痛的仔细检查,我们诊断出胃癌和胆囊结石。由于术前诊断为T2N0M0,ⅠB期,我们进行了手术。术中发现许多小结节,术后病理诊断为腹膜转移。胃体部肿瘤已浸润至胃浆膜外。我们判断无法进行根治性切除,于是在腹腔内给予85mg顺铂(CDDP)后结束手术。术后进行了3个疗程的S-1/CDDP联合化疗。由于我们观察到主要病灶缩小,且未发现腹膜转移和腹水,于是进行了二次探查手术。发现腹膜和直肠子宫陷凹处的所有结节均已消失,遂进行了远端胃切除术。术后诊断为pT2(MP),pN0CY0,ⅠB期,Cur A,治疗分级1a。化疗取得了成功,这是一例能够进行根治性手术的宝贵病例。